Individual
JENNIFER KRUSEMARK-MILLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4320 CLEVELAND AVE. SE, CANTON, OH 44707
(330) 484-2584
(330) 484-3529
Mailing address
6046 WHIPPLE AVE NW, NORTH CANTON, OH 44720-7616
(330) 484-2584
(330) 484-3529
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34008389
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2687570
—
OH
01
—
34008389
LICENSE
OH
Enumeration date
07/12/2006
Last updated
10/02/2012
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